A novel, fully implantable, multichannel biotelemetry system for measurement of blood flow, pressure, ECG, and temperature.

Biotelemetry provides high-quality data in awake, free-ranging animals without the effects of anesthesia and surgery. Although many biological parameters can be measured using biotelemetry, simultaneous telemetric measurements of pressure and flow have not been available. The objective of this study was to evaluate simultaneous measurements of blood flow, pressure, ECG, and temperature in a fully implantable system. This novel system allows the measurement of up to four channels of blood flow, up to three channels of pressure, and a single channel each of ECG and temperature. The system includes a bidirectional radio-frequency link that allows the implant to send data and accept commands to perform various tasks. The system is controlled by a base station decoder/controller that decodes the data stream sent by the implant into analog signals. The system also converts the data into a digital data stream that can be sent via ethernet to a remote computer for storage and/or analysis. The system was chronically implanted in swine and alligators for up to 5 wk. Both bench and in vivo animal tests were performed to evaluate system performance. Results show that this biotelemetry system is capable of long-term accurate monitoring of simultaneous blood flow and pressure. The system allows, within the room, recordings, since the implant transmission range is between 6 and 10 m, and, with a relay, backpack transmission distance of up to 500 m can be achieved. This system will have significant utility in chronic models of cardiovascular physiology and pathology.

Three-dimensional computerized reconstruction. Illustration of incremental articular cartilage thinning.

RATIONALE AND OBJECTIVES: The authors have addressed the ability of magnetic resonance (MR) imaging to resolve incremental thinning of articular cartilage by assessment of three-dimensional (3-D) and two-dimensional (2-D) representations. METHODS: Using a porcine knee model, sequential cartilage shavings were characterized using a 3-D fat suppressed spoiled gradient-echo (SPGR) MR imaging protocol that provided good contrast between high-signal articular cartilage and lower signal surrounding tissues. Lesion dimensional measurements were made on both MR images and 3-D computerized reconstructions. Volumes of cartilage removed were approximately 0.06 mL. RESULTS: Incremental articular cartilage thinning typically was apparent on 3-D reconstructed images. Three-dimensional articular cartilage reconstructions were effective in depicting location and orientation of shaved cartilage regions. Average percent error associated with length and with measurements based on 2-D MR images was approximately 19% for observer 1 and 33% for observer 2 when compared with direct measurements of the shaved cartilage. Average percent error of thickness measurements based on 2-D MR was approximately 21% for observer 1 and 37% for observer 2. Overall average errors associated with length, width, and thickness measurements were approximately 25%. CONCLUSIONS: Incremental thinning of articular cartilage can be tracked qualitatively and quantitatively using 3-D computerized reconstructions and 2-D MR images. Errors associated with the quantitative measurements can be attributed to limitations of measurement methods and intrinsic limitation of MR resolution.

Analysis of three-dimensional computerized representations of articular cartilage lesions.

RATIONALE AND OBJECTIVES: The authors assess the accuracy of three-dimensional (3D) computer representations based on magnetic resonance images of articular cartilage lesions, using actual cartilage lesions as reference standards. METHODS: Grade 2 and grade 3 articular lesions were created on articular surfaces of five porcine knee joints. The knees were then imaged using 3D fat-suppressed SPGR acquisition at four different slice thicknesses. Magnetic resonance imaging data sets were transferred to a computer workstation for image processing and 3D reconstruction. Lesion dimensions (length, width, and depth) based on the 3D reconstructed image were compared with the dimensions measured using actual lesions. RESULTS: The average percent error of lesion length, width, and depth based on the 3D images ranged from approximately 8% to 12% when using the thinnest magnetic resonance slice thickness (0.7 mm). CONCLUSIONS: Three-dimensional reconstructed images derived from thin-slice magnetic resonance imaging can provide reasonable representations of true articular cartilage lesion dimensions.

The protective effect of hypoxic preconditioning on cortical neuronal cultures is associated with increases in the activity of several antioxidant enzymes.

Preconditioning describes a variety of treatments that induce neurons to become more resistant to a subsequent ischemic insult. How preconditioned neurons adapt to subsequent ischemic stress is not fully understood, but is likely to involve multiple protective mechanisms. We hypothesized hypoxic preconditioning induces protection by a coordinated up-regulation of antioxidant enzyme activity. To test this hypothesis, we developed two in vitro models of ischemia/reperfusion, involving oxygen-glucose deprivation (OGD) where neuronal cell death was predominantly by necrosis (necrotic model) or programmed cell death (PCD model). Hypoxic preconditioning 24 h prior to OGD significantly reduced cell death from 83% to 22% in the necrotic model and 68% to 11% in the PCD model. Consistent with the hypothesis, the activity of the antioxidant enzymes glutathione peroxidase, glutathione reductase, and Mn superoxide dismutase were significantly increased by 54%, 73% and 32%, respectively, in neuronal cultures subjected to hypoxic preconditioning. Furthermore, superoxide and hydrogen peroxide concentrations following OGD were significantly lower in the PCD model that had been subjected to hypoxic preconditioning.

Hyperalimentation for superior mesenteric-artery (cast) syndrome following correction of spinal deformity.

The cast syndrome, recently called the superior mesenteric-artery syndrome, is a well recognized complication that can occur after a body cast has been applied. We are reporting the cases of three patients who had this syndrome following surgical correction of spinal deformity. The complication failed to resolve with the usual non-operative measures but did resolve with treatment by total parenteral nutrition.

Knee joint accessory motion following anterior cruciate ligament allograft reconstruction: a preliminary report.

Early in the postoperative period, changes in tibial translation have been noted in patient populations following anterior cruciate ligament reconstructive surgery. Deformation due to a lengthening of the ligament graft has been the most widely accepted reason for the change in tibial translation. Treatment techniques have not been proven successful in the abatement or reversal of this graft lengthening. The purpose of this study was to investigate the effect of functional bracing on tibial translation during the first year postoperatively in a group of patients with early changes in tibial translation. Three consecutive patients with early increases in KT-2000 manual maximum total drawer following bone-patellar tendon-bone allograft reconstruction were identified as subjects in the control group. Five consecutive anterior cruciate ligament bone-patellar tendon-bone allografts with early increases in KT-2000 manual maximum total drawer were identified as subjects in the treatment group. These patients were followed monthly during the first year postoperatively by manual maximum total drawer KT-2000 testing. Criteria for inclusion in the treatment and control groups included KT-2000 testing, with an increase in translation of greater than or equal to 2 mm when compared with the uninvolved knee during the first year postoperatively. The treatment group was required to wear a functional knee brace during all weight-bearing activities until KT-2000 displacement measures were stabilized for 3 consecutive months. Treatment with the functional brace resulted in a mean 2.3-mm decrease in tibial translation in the manual maximum total drawer KT-2000 when comparing the involved and uninvolved knee prebracing with posttreatment. All five subjects in the treatment group had a decrease in tibial translation. A Median Test comparing the control and treatment group's KT-2000 scores was significant at the p < .05 level. Patients who experience early increases in tibial translation with anterior cruciate ligament reconstructions may be assisted in a reduction of the displacement by the use of a functional brace.

A measurement of anterior tibial displacement in the closed and open kinetic chain.

Anterior displacement of the tibia during knee extension movement has been identified as a possible factor in anterior cruciate ligament (ACL) reconstruction failure due to the increased stress placed on the graft, leading to a creep response in the healing graft. Nineteen healthy subjects with a unilateral ACL deficiency were evaluated in an open and closed kinetic chain. A KT-1000 was used to measure anterior displacement of the tibia on the femur during isometric open and closed kinetic chain exercise at 30 and 60 degrees. An analysis of variance for repeated measures followed by Newman-Keuls multiple comparison tests were performed to determine the differences between the open and closed kinetic chain for the involved and uninvolved knee. Statistically significant differences were found when comparing the amount of anterior displacement between the open and closed kinetic chain for the involved and uninvolved knee at 30 and 60 degrees. Clinicians utilizing isometric exercise in rehabilitation of the anterior-cruciate-deficient and the anterior-cruciate-reconstructed patient should be aware of the increased amount of anterior tibial displacement when comparing open and closed kinetic chain exercise.

Novel phage peptides attenuate beta amyloid-42 catalysed hydrogen peroxide production and associated neurotoxicity.

Amyloid-beta (Abeta) peptides play a central role in the pathogenesis of Alzheimer's disease. There is accumulating evidence that supports the notion that the toxicity associated with human Abeta (both 40 and 42) is dependent on its superoxide dismutase (SOD)-like activity. We developed a novel screening method involving phage display technology to identify novel peptides capable of inhibiting Abeta's neurotoxicity. Two random peptide libraries containing 6-mer and 15-mer peptide inserts were used and resulted in the identification of 25 peptides that bound human Abeta (40 or 42). Here, we show that two of the three most enriched peptides obtained significantly reduced Abeta42's SOD-like activity. A 15-mer peptide reduced Abeta42 neurotoxicity in a dose-dependent manner as evidenced by a reduction in LDH release. These findings were confirmed in the independent MTT assay. Furthermore, comparative analysis of the 15-mer peptide with Clioquinol, a known inhibitor of Abeta's metal-mediated redox activity, showed the 15-mer peptide to be equipotent to this metal chelator, under the same experimental conditions. These agents represent novel peptides that selectively target and neutralise Abeta-induced neurotoxicity and thus provide promising leads for rational drug development.

Metabolic and blood gas dependence on digestive state in the Savannah monitor lizard Varanus exanthematicus: an assessment of the alkaline tide.

A large alkaline tide (up to 20 mmol l(-1) increase in bicarbonate concentration [HCO3-] with an accompanied increase in blood pH) has previously been reported for some carnivorous reptiles within 24 h after ingesting a large meal. This phenomenon has been attributed to the secretion of large amounts of H+ ions into the stomach, which is required for digestion of large prey items. To test the generality of this phenomenon in carnivorous reptiles, this study quantified the metabolic and acid-base status of the Savannah monitor lizard, Varanus exanthematicus, during digestion at 35 degrees C. Following a meal of approximately 10% of body mass, V(O2) and V(CO2) were measured continuously and arterial pH, blood gases and strong ions were measured every 8 h for 5 days. During peak digestion (24 h post feeding), V(O2) and V(CO2) increased to approximately threefold fasting values (V(O2), 0.95-2.57 ml min(-1) kg(-1); V(CO2) 0.53-1.63 ml min(-1) kg(-1)) while respiratory exchange ratio (R) remained constant (0.62-0.73). During digestion, arterial P(CO2) increased (from 4.6 kPa to 5.8 kPa), and [HCO3-] also increased (from 24.1 mmol l(-1) to 40.3 mmol l(-1)). In contrast to early studies on crocodilians, arterial pH in V. exanthematicus remained relatively stable during digestion (7.43-7.56). Strong ions contributed little to the acid-base compensation during the alkalosis. Collectively the data indicate that the metabolic alkalosis associated with H+ secretion (as indicated by increased plasma bicarbonate) is partially compensated by a respiratory acidosis.

Recovery from an activity-induced metabolic acidosis in the American alligator, Alligator mississippiensis.

The metabolic acidosis resulting from an intense exercise bout is large in crocodilians. Here we studied recovery from this pH perturbation in the American alligator. Metabolic rate, minute ventilation, arterial pH and gases, and strong ion concentration were measured for 10 h after exhaustion to elucidate the mechanisms and time course of recovery. Exhaustion resulted in a significant increase in lactate, metabolic rate, and ventilation, and a decrease in arterial PCO2), pH and bicarbonate. By 15 min after exhaustion, oxygen consumption returned to rest though carbon dioxide excretion remained elevated for 30 min. Arterial PO2), [Na+], and [K+], increased following exhaustion and recovered by 30 min post-exercise. Minute ventilation, tidal volume, [Cl-], and respiratory exchange ratio returned to resting values by 1 h. The air convection requirement for oxygen was elevated between 15 and 60 min of recovery. Breathing frequency and pH returned to resting values by 2 h of recovery. Lactate levels remained elevated until 6 h post-exercise. Arterial PCO2) and [HCO3-] were depressed until 8 h post-exercise. Compensation during recovery of acid-base balance was achieved by altering ventilation: following the initial metabolic acidosis and titration of bicarbonate, a relative hyperventilation prevented a further decrease in pH.

Promoting awareness: the mother and her baby.

This study considered the problem of how to increase a mother's awareness of her infant's behavior and her own behavior as a beginning step toward the promotion of quality interaction between mother and infant. The impact of informing 108 mothers of term infants and 32 mothers of preterm infants about: (a) neonatal interactive, motoric, state control, and response to stress behavior patterns; and (b) maternal behaviors to enhance and support infant behavior was tested with four groups. In describing the behavior that occurred during a feeding session, mothers in two treatment groups reported significantly more of their own behavior than that of their neonate. They more closely resembled the trained observers' report of the behavior than did mothers in two control groups. Recommendations include incorporating an educative treatment in plans of nursing care for mothers and infants and further research to determine the optimal timing and long-term effects of such an intervention.

Effects of pretwist on biomechanical properties of canine patellar tendon.

The purpose of this study was to measure the effect produced on canine patellar tendon of a 90 degree pretwist on the following mechanical properties: failure stress, failure strain, average elastic modulus, and strain energy density. Forty adult mongrel dog cadavers, killed for other studies, were used. Paired patellar tendons were isolated with patellar and tibial bone and the central 4.0-4.6 mm of tendon used for testing. Specimens were elongated to failure using a Materials Testing System (MTS). Only those paired specimens both failing in substance were analyzed. Eight paired specimens were analyzed, both with 0 degree twist, for right-left reproducibility. Thirty-two paired specimens were randomly assigned to four groups: right 0 degree/left 90 degree clockwise pretwist; right 0 degree/left 90 degree counterclockwise; left 0 degree/right 90 degree clockwise; left 0 degree/right 90 degree counterclockwise. No statistically significant differences were present between the paired untwisted specimens in any mechanical property. In the pretwisted specimens, there were statistically significant differences between the group left/clockwise and right/counterclockwise and the group left/counterclockwise and right/clockwise with respect to the mechanical properties failure stress, average elastic modulus, and strain energy density. No statistically significant differences were observed between the two groups for failure strain. For the canine patella-patellar tendon-tibia complex (PPTTC), the mechanical properties failure stress, average elastic modulus, and strain energy density are sensitive to both side (left/right) of PPTTC and direction (clockwise/counterclockwise) of pretwist. Pretwist of patellar tendon grafts in anterior cruciate ligament reconstruction may produce significant changes in their mechanical properties that vary with the direction of twist.

The effects of environmental temperature, hypoxia, and hypercapnia on the breathing pattern of saltwater crocodiles (Crocodylus porosus).

This study aimed to describe the effects of change in environmental temperature, hypoxia, and hypercapnia on the breathing pattern of Crocodylus porosus. Increased environmental temperature, hypoxia, and hypercapnia each caused an increase in minute ventilation and changes in breathing pattern. Breathing frequency increased and the duration of the nonventilatory period decreased in response to all three conditions. Under hypercapnia tidal volume also increased, with no change in rate of inspiration. The number of breaths per breathing burst decreased with increased temperature but remained unaltered under hypoxia. Hypercapnia reduced the number of breaths per burst at 20 degrees C, but the number did not decrease further at 30 degrees C. The results support the idea that the responses to increased temperature, hypoxia, and hypercapnia are under separate control but that some effects of hypercapnia and temperature may involve a common regulatory pathway.

Pulmonary vagal modulation of ventilation in toads (Bufo marinus).

This study examined the role of pulmonary vagal feedback on hypercapnic chemosensitivity and breathing pattern formation in cane toads (Bufo marinus). Decerebrate, paralysed toads were uni-directionally ventilated with air, 2.5% CO(2) or 5.0% CO(2) with the lungs inflated or deflated, before and after pulmonary vagotomy. Motor output from the mandibular branch of the trigeminal nerve served as an index of fictive breathing. As respiratory drive was increased, breathing frequency increased and breaths were clustered into discrete episodes separated by periods of apnea. Lung deflation tended to enhance episodic breathing while inflation biased the system towards apnea at low levels of respiratory drive and a pattern of continuous, small breaths at higher levels of respiratory drive. Following bilateral pulmonary vagotomy there was no increase in ventilation during hypercapnia and lung inflation/deflation had no effect on breathing pattern. In isolated brainstem-spinal cord preparations from the same animals, all variables associated with fictive breathing were unaffected by changes in superfusate pH from 8.0 to 7.6. The breathing pattern from the in vitro preparations was highly variable. This study demonstrates a crucial role for vagal feedback in modulating respiration and the respiratory responses to hypercapnia in B. marinus.